Mbeki's HIV Stand Angers Delegates / Hundreds walk out on his speech

Sabin Russell, Chronicle Staff Writer

Published 4:00 am, Monday, July 10, 2000

2000-07-10 04:00:00 PDT Durban, South Africa -- South African President Thabo Mbeki, opening the first international AIDS conference in a developing country, insisted yesterday that poverty is a greater enemy than the virus that 10,000 delegates came here to battle.

The successor to Nelson Mandela disappointed thousands of AIDS researchers and activists who had hoped he would issue a clarion call for an international war against the disease. As he spoke, hundreds of delegates to the 13th International AIDS Conference walked out.

Many wanted him to declare, once and for all, that HIV is indeed the cause of AIDS, ending months of controversy sparked when he entertained the theories of skeptics, including University of California at Berkeley virologist Peter Duesberg. Instead, he reiterated his own doubts: "It seemed to me that we could not blame everything on a single virus."

Mbeki pointedly ignored the so- called Durban Declaration, signed by 5,000 AIDS researchers and physicians and released last week, which states unequivocally that "HIV causes AIDS. It is unfortunate that a few vocal people continue to deny the evidence. This position will cost countless lives."

However, the South African leader accused his own critics of intolerance. "Some in our common world consider the questions that I and the rest of our government have raised around the HIV/AIDS issue . . . as akin to grave criminal and genocidal conduct," he said. "What I hear being said repeatedly, stridently, angrily, is 'Do not ask any questions!' "

In six months, the president said, a committee he commissioned will deliver a report assessing the reliability of HIV tests and proposing ways to improve the country's disease surveillance system, which assesses the extent of the AIDS epidemic with estimates rather than hard counted numbers.

South Africa has become a center of the AIDS epidemic, with more people living with the virus than any other nation. Twenty percent of South Africa's adult population, or 4.2 million people, are believed to be infected with HIV.

Mbeki nevertheless struck a chord with many delegates by casting all of Africa's health problems as the product of an economic imbalance. "Extreme poverty is the world's biggest killer and the greatest cause of health and suffering across the globe," he said, citing a 5-year-old World Health Organization report.

The president also made an impassioned plea to the West to give Africans something more than a list of the continent's shortcomings.

'HOPE FOR BETTER TOMORROW'

"We are a country and a continent driven by hope, and not despair and resignation to a cruel fate," he said. "Those who have nothing would perish if the forces that govern our universe deprived them of the capacity to hope for a better tomorrow."

Mbeki called for an intensified program to encourage condom use, and to treat sexually transmitted diseases. He cited his own government's effort to fund research on an AIDS vaccine, and called for further research on antiviral drugs.

John James, editor of AIDS Treatment News of San Francisco, said critics of Mbeki may be overlooking the importance of his emphasis on the economic roots of disease. He said there has been too much emphasis on getting the proud leader to recant his flirtation with people who deny that HIV causes AIDS. "He used the term HIV/AIDS, repeatedly," said James. "He didn't give us a mea culpa, but why do we need that?"

Linus Ettyang, a demographer from Nairobi, Kenya, said he saw positive aspects to the Mbeki speech. He felt that the issue of poverty outlined by the World Health Organization memo was an important factor often overlooked. "The idea of bringing a variety of experts to look into questions about testing is a good thing," he said. "But the end of the year is a little bit late."

SPEECH SET POOR TONE

Chris Rodel, a South African man who is living with AIDS in London, said the speech was political and set a poor tone. "If poverty was such a big issue," he asked, "then why are we spending billions on defense?"

Mbeki's welcoming address at the opening ceremony, held before 12,000 spectators at the Kings Mead outdoor cricket stadium near the conference site, capped a long day of activities surrounding the opening of the conference.

In midafternoon, several thousand demonstrators singing, chanting and dancing marched from Durban City Hall to the stadium, calling on world pharmaceutical makers to cede the Third World market to generic drugmakers capable of producing AIDS drugs for a fraction of the cost.

Doctors Without Borders, the Nobel Peace Prize-winning French medical organization, issued a report yesterday estimating that the combination of antiviral drugs that have saved thousands of lives in the United States -- at a cost of more than $12,000 per year -- could be sold by generic producers for as little as $200 for a year's supply.

Before the march, Dr. Peter Mugyenyi, an AIDS clinician at Uganda's Joint Clinical Research Center, told a gathering of activists that the stark contrasts in availability of drugs to treat Africa's dying poor is no longer tolerable. "Drugs are where the disease is not," he said. "The disease is where the drugs are not."

DRUG DISCOUNTS SPURNED

Mugyenyi dismissed the offers by pharmaceutical giants to negotiate steep discounts in AIDS drugs. "If they are not going to reduce the cost, then just shut up," he told a cheering crowd inside Durban City Hall. "It is not a negotiable situation."

Just before the march began, Justice Edwin Cameron, a judge of the High Court of South Africa, told the gathering that the prospect of 25 million deaths in Africa is fundamentally unacceptable. He described a growing fatalism in the West's perception of the "sad realities" of Africa's problems. "We don't accept 'sad realities' in South Africa," he said. "If we accepted sad realities, we would still have a racist oligarchy here."

Cameron, a gay man with AIDS, described how he nearly died of the disease three years ago but was brought back to health by antiretroviral drugs he was able to afford.

"I have the privilege of purchasing my health, for about $400 a month. Why should I have the privilege of purchasing my life, when 34 million people around the world are becoming ill and dying? It is a moral inequity of fundamental proportions. No one can look at it and not be spurred to action."